The world of sleep medicine has changed in many ways over the last 40 years. In the beginning most of the sleep apnea patients were old fat men and the treatment was often a tracheotomy. Surgery to remove the uvula, soft palate and reconstrcyt the throat became the rage next in spite of extremely poor results, high morbidity and pain. The CPAP machine was invented by Australian Colin Sullivan and it provided a new world of sleep apnea treatment.

CPAP, or Continuos Positive Air Pressure is basically a Mask, A Hose and a Compressor that takes room air and forces it through the hose and mask and into the nose, mouth or both and into the lungs. It actually works to stent the airway open.

The first CPAP machines were crude, loud, bulky with uncomfortable masks and heavy hoses that delivered dry air. Most patients id not like or use CPAP due to discomfort but it was effective. In fact,only 25 % of patients actually used their CPAP machines all night on a regular basis.

The newest machines are quiet, humidified small, sleep and much more comfortable with hundreds if not thousands of possible combinations of masks, hoses (now heated) humidifiers , monitoring, and comfort feature like ramping, APAP, BiPAP and more.

Has CPAP usage expanded? Unfortunately only about 25% of patients use their machine as directed and most do not even meet the medicare guidlines of four hours/ night four nights a week. That combination leaves 70% of sleep Apnea untreated in those patient.

The big secret not told to most patients struggling with CPAP is that at least 60% of patients fail CPAP and give it up entirely. The scandalous part of this is that the majority of patients now receive no treatment and many are not informed about oral appliance therapy, the comfortable alternative to CPAP.

Oral Appliance therapy was a Chicago invention or at least was born into Chicago thanks to the mother of Oral Appliance Therapy Dr Rosalind Cartwright of Rush medical school who published the first peer reviewed articles on oral appliance therapy with the TRD or Tongue Retaining Device and importantly also was the first sleep expert to publish on position sleep apnea.

It should interest everyone who has had a problem with CPAP that Colin Sullivan, the man who invented CPAP utilizes an oral appliance to treat his sleep apnea. Dr John Remmers a Canadian physician who
invented the term Sleep Apnea is an enthusiastic supporter of oral appliance therapy as the first line treatment of Obstructive Sleep Apnea.

The number one reason patients don’t use CPAP is “I Hate CPAP!!” The website I created www.IHateCPAP.com was not named because I hate CPAP but was named because it was the number one reason patients gave when they came looking for an oral appliance treatment of Sleep Apnea. The I Hate CPAP website created a stir in the field of Dental Sleep Medicine and was on Radio, TV, Newspapers, Magazines and Social Media. It brought floods of patients who hat abandoned CPAP back to the field of sleep medicine. It was partially responsible for a boom in sleep treatment as patients were willing to have sleep tests if there were chices other than CPAP and ineffective painful surgery with low efficay and high levels of morbidity.

Polotics blew in a powerful storm primarily due to the power and money of companies who made CPAP. I Hate CPAP was banned from Academy of Sleep Medicine and Academy of Dental Sleep Medicne meetings and I was actually told by an oral surgeon and past president of the AADSM that it was better to let people die then market I Hate CPAP! This in spite of the fact that 60% of patients abandoned CPAP

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